Maintaining hand hygiene can curb 40% of ICU infections, say experts

Health experts have said about 40% infections in intensive care units (ICUs) can be avoided by maintaining hand hygiene, which is regarded as one of the most important elements of infection control activities.Ranjana Diggikar | TNN | January 01, 2016, 13:02 IST

(Getty Images photo)Aurangabad: Health experts have said about 40% infections in intensive care units (ICUs) can be avoided by maintaining hand hygiene, which is regarded as one of the most important elements of infection control activities.

A large proportion of these hospital infections are easily preventable with by stepping up hygiene practices such as frequent hand-washing, they said.

"The hospital staff plays a key role to ensure that infection control procedures and practices are being implemented in an effective way to prevent patients from acquiring an infection. Lack of knowledge in these practices leads to high rate of health care-related infections, long stay of patients and unnecessary economic burden on them," said Anand Nikalje, intensivist and medical superintendent at MIT, a city-based charitable hospital. "Doctors and cleanliness should go hand in hand. But that may not be the case in reality. At least 40% of ICU infections can be averted by practising proper hand hygiene," he said.

A recent study by Lady Hardinge Medical College (LHMC) and All India Institute of Medical Sciences (AIIMS) revealed that not many doctors have the habit of washing hands and following other hygienic practices. Published in the latest issue of International Journal of Pharma Research and Health Sciences, the study was carried out through an evaluation test from March to May 2015 in the form of a questionnaire given to more than 100 doctors and nurses during a training session.

Experts said implementation and adherence to hand hygiene practices in a healthcare facility can prevent infections and limit the transmission of micro organisms.

L S Deshmukh, head of the neo-natal intensive care unit (NICU) department at the Government Collge and Hospital (GMCH), said, "At the NICU of our hospital, it is mandatory for every person to get a two-minute hand wash before entering. Moreover, the staff has been also instructed to go for a 30-second hand wash in between each patient examination so that ICU infections are averted."

"But unfortunately, hand hygiene is not followed at more than 50% hospitals across the globe, which is posing a big health challenge. Infections through hand are deadlier as they carry organisms which are multi-drug resistant and come from hospital environment. Hence, extra care is required," he said.

However, Deshmukh said it becomes difficult to follow the guidelines at public hospitals, which are overcrowded and under-staffed.

Shrikant Sahastrabuddhe, intensivist at Kamalnayan Bajaj Hospital, said it has been found that most of the doctors still believe that soap and water is the best way of ensuring hand hygiene, even though the World Health Organisation (WHO) recommends alcohol-based hand rub as it is acts fast and has broad spectrum of antimicrobial activity.

"Poor hand hygiene practices are a major threat and pose a huge risk to the health of patients. If followed in proper manner, we can avert about 25-30% infections in ICUs," he said.

"There is also a need for orientation programmes for the newcomers to understand the significance of hand hygiene. WHO has recommended five movements of hand, which include hand wash before touching the patient, before the patient's cleaning procedure, after touching the patient's body fluid catheter, after touching the patient and the patient's surroundings," he added.

Only in India the healthcare financing is very small when compared to the financing by the other forces rather than the patient himself or herself paying out of pocket. Having 70-75% of the expenses as out-of-pocket, in my opinion, is not a right approach to managing healthcare in a country where the patients tend to sub-optimally purchase healthcare if he/she has to pay out-of-pocket.